Skip to main content
SpringerLink
Log in

Self-regulating service delivery systems: A model for children and youth at risk

  • Articles
  • Published:
The Journal of Behavioral Health Services & Research Aims and scope Submit manuscript

Abstract

A conceptual model of self-regulating service delivery is proposed for use by governments, planners, and policymakers to help children reach optimal adult functioning. It addresses most problems of present service delivery and is applicable to children in the general population and registered consumers of mental health, child welfare, special education, drug dependency, and juvenile justice (young offender) services. It has four essential components: (1) outcome measurements that reflect the mental health statuses of children in services and in the general population; (2) regular feedback of these measurements to governments, the public, and service delivery organizations; (3) powerful and significant rewards and incentives for the most desired outcomes to increase their salience and to motivate provider behavior; and (4) decision making that can affect all entities that contribute to the health of children. The evaluable expected benefits are improved mental health for children and greater efficiency within the “system.”

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Stroul BA, Friedman RM:A System of Care for Severely Emotionally Disturbed Children and Youth. Washington, DC: Georgetown University Child Development Center, Child and Adolescent Service System Program Technical Assistance Center, 1986.

    Google Scholar 

  2. Culbertson JL: Clinical child psychology in the 1990s: Broadening our scope.Journal of Clinical Child Psychology 1993; 22:116–122.

    Google Scholar 

  3. Junek W:Problems Serving Children at Risk: Observations and Issues. Paper presented at annual meeting of the Child Welfare League of Canada, Halifax, Nova Scotia, June 17, 1994.

  4. Henggeler SW: A consensus: Conclusions of the APA Task Force Report on innovative models of mental health services for children, adolescents and their families.Journal of Clinical Child Psychology 1994; 23(Suppl.):3–6.

    Google Scholar 

  5. Friedman RM: Restructuring of systems to emphasize prevention and family support.Journal of Clinical Child Psychology 1994; 23(Suppl.):40–47.

    Google Scholar 

  6. Federal/Provincial/Territorial Advisory Committee on Mental Health, Working Group on Child and Youth Mental Health:Foundations for the Future. Ottawa, Ontario: Health Canada, 1990.

    Google Scholar 

  7. Lerman P: Child welfare, the private sector, and community-based corrections.Crime & Delinquency 1984; 30:5–38.

    Google Scholar 

  8. Rutter M:Changing Youth in a Changing Society. London: Nuffield Provincial Hospitals Trust, 1979.

    Google Scholar 

  9. Thompson AH: Young offender, child welfare, and mental health caseload commonalities.Canadian Journal of Criminology 1988; 30:135–144.

    Google Scholar 

  10. Offord DR, Boyle MH, Szatmari P, et al.: Ontario Child Health Study: II. Six month prevalence of disorder and rates of service utilization.Archives of General Psychiatry 1987; 44:832–836.

    Google Scholar 

  11. Rae-Grant N, Offord DR, Munroe-Blum H: Ontario Child Health Study: Implications for clinical services, research and training.Canadian Journal of Psychiatry 1989; 34:492–499.

    Google Scholar 

  12. Ministry of Community and Social Services:Children's Services Policy Framework for Services Funded under the Child and Family Services Act. Toronto: Province of Ontario, Queen's Printer, 1993.

    Google Scholar 

  13. Ministry of Community and Social Services:Making Services Work for People. Toronto: Province of Ontario, Queens Printer, 1997.

    Google Scholar 

  14. Jordan DD, Hernandez M: The Ventura planning model: A proposal for mental health reform.Journal of Mental Health Administration 1990; 17:26–47.

    Google Scholar 

  15. Ichinose CK, Kingdon DW, Feltman R: System of care in California: Current status of the Ventura planning model. In: Epstein MH, Kutash K, Duchnowski AJ (Eds.):Community_2DBased Programming for Children with Serious Emotional Disturbances and Their Families. Austin, TX: Pro-2DEd, 1997, pp. 173–204.

    Google Scholar 

  16. Willie M. Section, Division of Mental Health/Developmental Disabilities/Substance Abuse Services, Department of Human Resources:Willie M. Services. Revised ed. Raleigh: Government of North Carolina, 1995.

  17. Willie M. Section, Division of Mental Health/Developmental Disabilities/Substance Abuse Services, Department of Human Resources:Willie M. Quality Improvement Process. Revised ed. Raleigh: Government of North Carolina, 1992.

  18. Department of Human Resources, Division of Mental Health/Developmental Disabilities/Substance Abuse Services, Department of Public Instruction:Exceptional Children's Support Team: Report to the Governor and the General Assembly of the Willie M. Program, 1996–97. Raleigh: Government of North Carolina, 1997.

    Google Scholar 

  19. Kagan SL, Neville P:Integrating Services for Children and Families: Understanding the Past to Shape the Future. New Haven, CT: Yale University Press, 1993.

    Google Scholar 

  20. Bickman L: A continuum of care: More is not always better.American Psychologist 1996; 51:689–701.

    Google Scholar 

  21. Miller JG:Living Systems. New York: McGraw-Hill, 1978.

    Google Scholar 

  22. Plante TG, Couchman CE, Diaz AR: Measuring treatment outcome and client satisfaction among children and families.Journal of Mental Health Administration 1995; 22:261–269.

    Google Scholar 

  23. Costello EJ, Burns BJ, Angold A, et al.: How can epidemiology improve mental health services for children and adolescents?Journal of the American Academy of Child and Adolescent Psychiatry 1993; 32:1106–1114.

    Google Scholar 

  24. Henggeler SW, Schoenwald SK, Pickrel SG, et al.: The contribution of treatment outcome research to the reform of children's mental health services: Multisystemic therapy as an example.Journal of Mental Health Administration 1994; 21:229–239.

    Google Scholar 

  25. Fabry BD, Hawkins RP, Luster WC: Monitoring outcomes of services to children and youth with severe emotional disorders: An economical follow-up procedure for mental health and child care agencies.Journal of Mental Health Administration 1994; 21:271–282.

    Google Scholar 

  26. Bickman L, Guthrie PR, Foster EM, et al.:Evaluating Managed Mental Health Services: The Fort Bragg Experiment. New York: Plenum, 1995.

    Google Scholar 

  27. Bartlett J, Cohen J: Building an accountable, improvable delivery system.Administration and Policy in Mental Health 1993; 21:51–58.

    Google Scholar 

  28. Schalock RL:Outcome-Based Evaluation. New York: Plenum, 1995.

    Google Scholar 

  29. Jenkins R: Towards a system of outcome indicators for mental health care.British Journal of Psychiatry 1990; 157:500–514.

    Google Scholar 

  30. Kane RL, Bartlett J, Potthoff S: Building an empirically based outcomes information system for managed mental health care.Psychiatric Services 1995; 46:459–461.

    Google Scholar 

  31. Mirin SM, Namerow MJ: Why study treatment outcome?Hospital and Community Psychiatry 1991; 42:1007–1013.

    Google Scholar 

  32. Minnesota Milestones: A Report Card for the Future. St. Paul, MN Planning, 1992.

  33. Oregon Benchmarks: Standards for Measuring Statewide Progress and Government Performance: Report to the 1993 Legislature. Salem: Oregon Progress Board, 1992.

  34. Thompson AH, Howard AW, Jin Y: A Social Problem Index for Canada. Unpublished manuscript, Alberta Health.

  35. Nelson DM, Pearson CA:Integrating Services for Children and Youth with Emotional and Behavioral Disorders. Reston, VA: Council for Exceptional Children, 1991.

    Google Scholar 

  36. Schor L:Within Our Reach: Breaking the Cycle of Disadvantage. New York: Anchor/Doubleday, 1988.

    Google Scholar 

  37. Felner RD, Brand S, Mulhall P, et al.: Restructuring the ecology of the school as an approach to prevention during school transitions: Longitudinal follow-ups and extensions of the School Transitional Environment Project (STEP).Prevention in Human Services 1993; 10:103–136.

    Google Scholar 

  38. Saxe L, Cross T, Silverman N: Children's mental health: The gap between what we know and what we do.American Psychologist 1988; 43:800–807.

    Google Scholar 

  39. Tremblay RE, Craig WM: Developmental crime prevention.Crime and Justice 1995; 19:479–564.

    Google Scholar 

  40. Hewlett SA:When the Bough Breaks. New York: HarperCollins/Basic Books, 1991.

    Google Scholar 

  41. Davis CK: Commitment and cost control in the health care system.American Psychologist 1982; 37:1359–1361.

    Google Scholar 

  42. Frank RG, Goldman HH: Financing care of the severely mentally ill: Incentives, contracts, and public responsibility.Journal of Social Issues 1989; 45:131–144.

    Google Scholar 

  43. Miller TR, Lestina DC, Galbraith MS: Patterns of childhood medical spending.Archives of Pediatric and Adolescent Medicine 1995; 149:369–373.

    Google Scholar 

  44. Aiming for Results: A Guide to Georgia's Benchmarks for Children and Families. Atlanta: Georgia Policy Council for Children and Families, 1996.

  45. Barker JA:Paradigms: The Business of Discovering the Future. New York: HarperCollins, 1992.

    Google Scholar 

  46. Kuhn T:The Structure of Scientific Revolutions. Third ed. Chicago: University of Chicago Press, 1966.

    Google Scholar 

  47. Peters TJ, Waterman RH, Jr.:In Search of Excellence. New York: Harper & Row, 1982.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mental Health Services, Department of Health, B3J 2R8, Halifax, Nova Scotia, P.O. Box 488, Canada

    Wade Junek M.D., F.R.C.P.C. (Child and Youth Consultant)

  2. Departments of Public Health Sciences and Psychiatry, University of Alberta, USA

    Angus H. Thompson Ph.D. (associate professor)

  3. the Health Surveillance Branch, Alberta Health, USA

    Angus H. Thompson Ph.D. (associate professor)

Authors
  1. Wade Junek M.D., F.R.C.P.C.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Angus H. Thompson Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wade Junek M.D., F.R.C.P.C..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Junek, W., Thompson, A.H. Self-regulating service delivery systems: A model for children and youth at risk. The Journal of Behavioral Health Services & Research 26, 64–79 (1999). https://doi.org/10.1007/BF02287795

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02287795

Keywords

Search

Navigation